An exercise cum cognitive-behavioral intervention for older adults with chronic pain: A cluster-randomized controlled trial

Objective: To examine the medium-term effects of a group intervention combining exercise and cognitivebehavioral strategies (EC) on older adults with chronic pain. Method: One hundred and fifty-two Hong Kong Chinese older adults with chronic pain affecting bones, muscles, and joints were randomized by clinic/social center to receive 10 weekly sessions of EC or pain education (control). The primary (pain intensity) and secondary outcomes (pain disability, pain self-efficacy, pain catastrophizing, pain coping, depressive symptoms, health-related quality of life, and hip and knee strength) were collected at baseline (T1), postintervention (T2), and 3- (T3) and 6-month follow-ups (T4). The trajectories of intervention effects were modeled by EC × time and EC × time² interaction terms in mixed-effects regression. Results: Significant EC × time and/or EC × time² interactions were found for pain intensity, pain disability, selfefficacy, and catastrophizing, such that the treatment effect leveled off (pain disability) or diminished (pain intensity and catastrophizing) over time, or continued to increase in a linear fashion (self-efficacy). There was also a treatment main effect on hip/knee muscle strength. Group differences in favor of EC were observed up to 3-month follow-up for pain intensity (d = −0.51) and hip/knee muscle strength (d = 0.38), and up to 6-month follow-up for pain disability (d = −0.60) and self-efficacy (d = 0.52). No group difference was found for catastrophizing at any time point. No treatment effects were found for the other outcomes. Conclusion: Older people suffering from chronic pain can benefit from a program incorporating both cognitive-behavioral techniques and physical exercise. Copyright © 2022 American Psychological Association.